Healthcare Provider Details

I. General information

NPI: 1023404928
Provider Name (Legal Business Name): MIELAD ABADY D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2015
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 S FOUR MILE RUN DR STE C4
ARLINGTON VA
22204-3559
US

IV. Provider business mailing address

4600 S FOUR MILE RUN DR STE C4
ARLINGTON VA
22204-3559
US

V. Phone/Fax

Practice location:
  • Phone: 703-671-4473
  • Fax:
Mailing address:
  • Phone: 703-671-4473
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN1001683
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: